A guideline for heavy ion radiation testing for Single Event Upset (SEU)

A guideline for heavy ion radiation testing for single event upset was prepared to assist new experimenters in preparing and directing tests. How to estimate parts vulnerability and select an irradiation facility is described. A broad brush description of JPL equipment is given, certain necessary pre-test procedures are outlined and the roles and testing guidelines for on-site test personnel are indicated. Detailed descriptions of equipment needed to interface with JPL test crew and equipment are not provided, nor does it meet the more generalized and broader requirements of a MIL-STD document. A detailed equipment description is available upon request, and a MIL-STD document is in the early stages of preparation

Direct Freeform Fabrication of Spatially Heterogeneous Living Cell-Impregnated Implants

The objectives of this work are the development of the processes, materials, and tooling to directly “3-D print” living, pre-seeded, patient-specific implants of spatially heterogeneous compositions. The research presented herein attempts to overcome some of the challenges to scaffolding, such as the difficulty of producing spatially heterogeneous implants that require varied seeding densities and/or cell-type distributions. In the proposed approach, living implants are fabricated by the layer-wise deposition of pre-cell-seeded alginate hydrogel. Although alginate hydrogels have been previously used to mold living implants, the properties of the alginate formulations used for molding were not suitable for 3-D printing. In addition to changing the formulation to make the alginate hydrogels “printable,” we developed a robotic hydrogel deposition system and supporting CAD software to deposit the gel in arbitrary geometries. We demonstrated this technology’s capabilities by printing alginate gel implants of multiple materials with various spatial heterogeneities, including, implants with completely embedded material clusters. The process was determined to be both viable (94±5% n=15) and sterile (less than one bacterium per 0.9 µL after 8 days of incubation). Additionally, we demonstrated the printing of a meniscus cartilage-shaped gel generated directly from a CT Scan. The proposed approach may hold advantages over other tissue printing efforts [5,9]. This technology has the potential to overcome challenges to scaffolding and could enable the efficient fabrication of spatially heterogeneous, patient-specific, living implants.Mechanical Engineerin

A vertical profile of deep horizontal current near Cape Lookout, North Carolina

The acoustic transit times for a float to sink to a bottom-anchored triangular array of disposable transponders are used to construct a horizontal current profile in the anticyclonic shear region of the Gulf Stream, southeast of Cape Lookout, North Carolina...

A case study evaluation of implementation of a care pathway to support normal birth in one English birth centre: anticipated benefits and unintended consequences

Background: The policy drive for the UK National Health Service (NHS) has focused on the need for high quality services informed by evidence of best practice. The introduction of care pathways and protocols to standardise care and support implementation of evidence into practice has taken place across the NHS with limited evaluation of their impact. A multi-site case study evaluation was undertaken to assess the impact of use of care pathways and protocols on clinicians, service users and service delivery. One of the five sites was a midwifery-led Birth Centre, where an adapted version of the All Wales Clinical Pathway for Normal Birth had been implemented. Methods: The overarching framework was realistic evaluation. A case study design enabled the capture of data on use of the pathway in the clinical setting, use of multiple methods of data collection and opportunity to study and understand the experiences of clinicians and service users whose care was informed by the pathway. Women attending the Birth Centre were recruited at their 36 week antenatal visit. Episodes of care during labour were observed, following which the woman and the midwife who cared for her were interviewed about use of the pathway. Interviews were also held with other key stakeholders from the study site. Qualitative data were content analysed. Results: Observations were undertaken of four women during labour. Eighteen interviews were conducted with clinicians and women, including the women whose care was observed and the midwives who cared for them, senior midwifery managers and obstetricians. The implementation of the pathway resulted in a number of anticipated benefits, including increased midwifery confidence in skills to support normal birth and promotion of team working. There were also unintended consequences, including concerns about a lack of documentation of labour care and negative impact on working relationships with obstetric and other midwifery colleagues. Women were unaware their care was informed by a care pathway. Conclusion: Care pathways are complex interventions which generate a number of consequences for practice. Those considering introduction of pathways need to ensure all relevant stakeholders are engaged with this and develop robust evaluation strategies to accompany implementation

A Reconstruction-Classification Method for Multifrequency Electrical Impedance Tomography

Multifrequency Electrical Impedance Tomography is an imaging technique which distinguishes biological tissues by their unique conductivity spectrum. Recent results suggest that the use of spectral constraints can significantly improve image quality. We present a combined reconstruction-classification method for estimating the spectra of individual tissues, whilst simultaneously reconstructing the conductivity. The advantage of this method is that a priori knowledge of the spectra is not required to be exact in that the constraints are updated at each step of the reconstruction. In this paper, we investigate the robustness of the proposed method to errors in the initial guess of the tissue spectra, and look at the effect of introducing spatial smoothing. We formalize and validate a frequency-difference variant of reconstruction-classification, and compare the use of absolute and frequency-difference data in the case of a phantom experiment

A realistic evaluation : the case of protocol-based care

Background 'Protocol based care' was envisioned by policy makers as a mechanism for delivering on the service improvement agenda in England. Realistic evaluation is an increasingly popular approach, but few published examples exist, particularly in implementation research. To fill this gap, within this paper we describe the application of a realistic evaluation approach to the study of protocol-based care, whilst sharing findings of relevance about standardising care through the use of protocols, guidelines, and pathways. Methods Situated between positivism and relativism, realistic evaluation is concerned with the identification of underlying causal mechanisms, how they work, and under what conditions. Fundamentally it focuses attention on finding out what works, for whom, how, and in what circumstances. Results In this research, we were interested in understanding the relationships between the type and nature of particular approaches to protocol-based care (mechanisms), within different clinical settings (context), and what impacts this resulted in (outcomes). An evidence review using the principles of realist synthesis resulted in a number of propositions, i.e., context, mechanism, and outcome threads (CMOs). These propositions were then 'tested' through multiple case studies, using multiple methods including non-participant observation, interviews, and document analysis through an iterative analysis process. The initial propositions (conjectured CMOs) only partially corresponded to the findings that emerged during analysis. From the iterative analysis process of scrutinising mechanisms, context, and outcomes we were able to draw out some theoretically generalisable features about what works, for whom, how, and what circumstances in relation to the use of standardised care approaches (refined CMOs). Conclusions As one of the first studies to apply realistic evaluation in implementation research, it was a good fit, particularly given the growing emphasis on understanding how context influences evidence-based practice. The strengths and limitations of the approach are considered, including how to operationalise it and some of the challenges. This approach provided a useful interpretive framework with which to make sense of the multiple factors that were simultaneously at play and being observed through various data sources, and for developing explanatory theory about using standardised care approaches in practice

Chemical reactivity of hydrogen, nitrogen and oxygen atoms at temperatures below 100 deg K Fifth semiannual technical report

Chemical reactivity of hydrogen, nitrogen, and oxygen atoms at temperatures below 100 deg

Large deviations provide good approximation to queueing system with dynamic routing

We consider a system with two infinite-buffer FCFS servers (of speed one). The arrivals processes are three independent Poisson flows Ξ_i , of rates λ_i, i = 0, 1, 2, each with IID task service times. The tasks from Ξ_i are directed to server i, i = 1, 2 (dedicated traffic). The tasks from Ξ_0 are directed to the server that has the shorter workload in the buffer at the time of arrival (opportunistic traffic). We compare the analytical data for the large deviation (LD) probabilities for the virtual waiting time in flow Ξ_0 and empercial delay freqencies from simulations

The implausibility of ‘usual care’ in an open system: sedation and weaning practices in Paediatric Intensive Care Units (PICUs) in the United Kingdom (UK)

Background: The power of the randomised controlled trial depends upon its capacity to operate in a closed system whereby the intervention is the only causal force acting upon the experimental group and absent in the control group, permitting a valid assessment of intervention efficacy. Conversely, clinical arenas are open systems where factors relating to context, resources, interpretation and actions of individuals will affect implementation and effectiveness of interventions. Consequently, the comparator (usual care) can be difficult to define and variable in multi-centre trials. Hence outcomes cannot be understood without considering usual care and factors that may affect implementation and impact on the intervention. Methods: Using a fieldwork approach, we describe PICU context, ‘usual’ practice in sedation and weaning from mechanical ventilation, and factors affecting implementation prior to designing a trial involving a sedation and ventilation weaning intervention. We collected data from 23 UK PICUs between June and November 2014 using observation, individual and multi-disciplinary group interviews with staff. Results: Pain and sedation practices were broadly similar in terms of drug usage and assessment tools. Sedation protocols linking assessment to appropriate titration of sedatives and sedation holds were rarely used (9 % and 4 % of PICUs respectively). Ventilator weaning was primarily a medical-led process with 39 % of PICUs engaging senior nurses in the process: weaning protocols were rarely used (9 % of PICUs). Weaning methods were variably based on clinician preference. No formal criteria or use of spontaneous breathing trials were used to test weaning readiness. Seventeen PICUs (74 %) had prior engagement in multi-centre trials, but limited research nurse availability. Barriers to previous trial implementation were intervention complexity, lack of belief in the evidence and inadequate training. Facilitating factors were senior staff buy-in and dedicated research nurse provision. Conclusions: We examined and identified contextual and organisational factors that may impact on the implementation of our intervention. We found usual practice relating to sedation, analgesia and ventilator weaning broadly similar, yet distinctively different from our proposed intervention, providing assurance in our ability to evaluate intervention effects. The data will enable us to develop an implementation plan; considering these factors we can more fully understand their impact on study outcomes